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NCJ Number:

186803

Title:

Therapeutic Communities: Diversity in Treatment Elements

Journal:

Substance Use and Misuse: An International Interdisciplinary Forum Volume:35 Issue:12-14 Dated:2000 Pages:1819-1847

Author(s):

Gerald Melnick; George De Leon; Matthew L. Hiller; Kevin Knight

Date Published:

2000

Annotation:

This study addresses the need to describe the diversity of
therapeutic community (TC) programs, using the Survey of
Essential Elements Questionnaire (SEEQ) to develop a typology of
TC programs based on 19 programs that identified themselves as
traditional modified TCs in the Drug Abuse Treatment Outcome
Studies (DATOS).

Abstract:

As part of the DATOS, the third in a series of National Institute
on Drug Abuse-funded national evaluations of community-based
substance user treatment, data were collected between 1991 and
1993 from 96 treatment programs in 11 cities throughout the
United States. The facilities were selected to obtain a
nationally representative sample of treatment programs in
community settings; they included 29 outpatient methadone
maintenance programs, 32 outpatient drug-free programs, 21
long-term residential programs, and 19 short-term inpatient
programs. To meet the objectives of this study, the sample was
limited to the 19 long-term residential programs whose directors
completed a survey distributed in 1994. Measures encompassed data
collection procedures, philosophy and treatment elements,
motivation scales, case mix, operational characteristics, and
retention and engagement. The survey found that traditional and
modified TCs differed in their adherence to the elements of TC
treatment, on operational characteristics, and in client mix.
Differences in treatment philosophy and approach included the
emphasis on self-reliance and the use of work as a therapeutic
agent for traditional TCs. There were also trends for
traditional TC programs to use community-as-method, to provide
educational and vocational training, and include family members
as part of therapy. Modified programs showed a greater tendency
to rely on counselors. Implications of these findings for program
quality, health care policy, and research are discussed. 3
tables, appended questionnaire, and 44 references

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